Analysis of the Influence of Abdominal Obesity on Systemic Arterial Hypertension and on the Lipid Profile on Cardiometabolic Risk Stratification in Adult Women

Abstract Background: Obesity is a public health problem and has been associated with the development of metabolic disorders that have a strong relationship with the onset of cardiovascular diseases (CVD). Objective: The objective was to analyze the influence of abdominal obesity (AO) on systemic arterial hypertension (SAH) and on the lipid profile in cardiovascular risk stratification in adult women. Methods: Altogether, 91 women participated in the research. Lifestyle information was collected, in addition to the analysis of clinical measures of cardiovascular risk and biochemical parameters. Unpaired Student's t-test, logistic regression, and Pearson's correlation were performed for data analysis, with a value of p <0.05 considered significant. Results: The prevalence of AO was 62.6%. Logistic regression showed that AO increased the chance of developing SAH by 2.9-fold. The same behavior was observed in the TG/HDL-c lipid ratio (3.93 ± 0.3 vs. 2.16 ± 0.2), representing an 82% increase in obese women. The present study also demonstrated that the best anthropometric parameter to analyze cardiovascular risk in the studied population was the waist/height ratio (AUC = 0.707). Conclusions: It can therefore be concluded that AO plays a significant role in the development of SAH and changes in lipid values that predict increased cardiovascular risk, configuring a strong influence factor for CVD.

Asociación entre factores de riesgo de enfermedad aterogénica en pacientes geriátricos / Association among risk factors for atherogenic disease in geriatric patients

RESUMEN Introducción: Las alteraciones del metabolismo lipídico constituyen un problema de salud muy frecuente, que se incrementan con la edad del individuo. Objetivo: Determinar la asociación entre factores de riesgo de enfermedad aterogénica en pacientes geriátricos atendidos en consulta del Hospital Universitario Clínico-Quirúrgico «Arnaldo Milián Castro¼. Métodos: Se realizó un estudio observacional, descriptivo, transversal, durante el período de septiembre de 2018 a septiembre de 2019. La muestra quedó conformada por 198 pacientes geriátricos, elegidos por muestreo probabilístico sistemático. Resultados: Predominó el sexo masculino; la edad de 60 a 69 años para ambos sexos, y el color de la piel blanca. Los factores clínicos de riesgo aterogénico más frecuentes fueron la hipertensión arterial y la diabetes mellitus. El perfil lipídico se caracterizó por valores elevados de colesterol total, VLDLc, LDLc, triglicéridos, apolipoproteína B, ambos índices lipídicos, y bajos de HDLc y apolipoproteínas A1. Conclusiones: Todas las determinaciones lipídicas mostraron significación estadística al relacionarlas con la edad, no siendo así con el sexo. La hipertensión arterial y la cardiopatía isquémica se asociaron de forma significativa con valores no deseables de colesterol total, VLDLc, LDLc, triglicéridos, apoproteína B y ambos índices lipídicos. La diabetes mellitus y el alcoholismo se asociaron con alteraciones de todas las fracciones lipídicas, excepto HDLc y apoproteína A1, respectivamente. Los pacientes fumadores presentaron valores no deseados de VLDLc, LDLc, e índice aterogénico, y los obesos de colesterol total, LDLc, triglicéridos y apoproteína B.

ABSTRACT Introduction: alterations in lipid metabolism are a very frequent health problem, which increase with the age of the individual. Objective: to determine the association among risk factors for atherogenic disease in geriatric patients treated in the consultation from "Arnaldo Milián Castro" Clinical and Surgical University Hospital. Methods: an observational, descriptive and cross-sectional study was carried out from September 2018 to September 2019. The sample was made up of 198 geriatric patients, chosen by systematic probabilistic sampling. Results: male gender, age from 60 to 69 years for both genders and white skin color predominated. The most frequent clinical atherogenic risk factors were arterial hypertension and diabetes mellitus. The lipid profile was characterized by high values of total cholesterol, VLDLc, LDLc, triglycerides, apolipoprotein B, both lipid indices, and low levels of HDLc and apolipoproteins A1. Conclusions: all lipid determinations showed statistical significance when relating them to age, but not to gender. Arterial hypertension and ischemic heart disease were significantly associated with undesirable values ​​of total cholesterol, VLDLc, LDLc, triglycerides, apoprotein B and both lipid indices. Diabetes mellitus and alcoholism were associated with alterations in all lipid fractions, except HDLc and apoprotein A1, respectively. Smokers had undesirable values ​​of VLDLc, LDLc, and atherogenic index, and obese patients of total cholesterol, LDLc, triglycerides, and apoprotein B.

Role of ferroptosis in hypoxia-reoxygenation injury in cardiomyocytes cultured in high-fat high-glucose medium / 中华麻醉学杂志

Objective:To evaluate the role of ferroptosis in hypoxia-reoxygenation (H/R) injury in cardiomyocytes cultured in high-fat high-glucose (HFHG) medium.Methods:Cardiomyocytes H9c2 cells were commonly cultured and divided into 3 groups ( n=20 each) using a random number table method: control group (C group), HFHG-H/R group and Ferrostatin-1 (Fer-1) plus HFHG-H/R group (Fer-1+ HFHG+ H/R group). H9c2 cells were cultured in a HFHG medium for 12 h and then exposed to 1%O 2-5%CO 2-94%N 2 for 4 h, followed by 2 h reoxygenation in a cell incubator.Fer-1 at a final concentration of 10 μmol/L was added while the cells were cultured in the HFHG medium in group Fer-1+ HFHG+ H/R.At 2 h of reoxygenation, the cell viability was measured using CCK-8 assay, the activity of lactate dehydrogenase (LDH) in the supernatant was measured using 2, 4-dinitrophenylhydrazine color method, the activity of reactive oxygen species (ROS) was measured by fluorescent probe DCFH-DA flow cytometry, and the expression of acyl-CoA synthetase long-chain family member 4 (ACSL4), nuclear receptor coactivator 4 (NCOA4), and glutathione peroxidase 4 (GPX4) was detected by Western blot. Results:Compared with group C, the cell viability was significantly decreased, the activities of LDH release and ROS were increased, and the expression of ACSL4 and NCOA4 was up-regulated ( P<0.05), and no significant change was found in the expression of GPX4 in group HFHG+ H/R ( P>0.05). Compared with group HFHG+ H/R, the cell activity was significantly increased, the activities of LDH and ROS were decreased, and the expression of ACSL4 and NCOA4 was down-regulated ( P<0.05), and no significant change was found in the expression of GPX4 in Fer-1+ HFHG+ H/R group ( P>0.05). Conclusions:Ferroptosis is involved in the process of H/R injury in cardiomyocytes cultured in HFHG medium.

The effect of hyperlipidemia on perioperative outcomes of rectal cancer patients / 中华老年医学杂志

Objective:To examine the influence of hyperlipidemia on perioperative outcomes of rectal cancer patients.Methods:From June 2016 to June 2019, 86 patients who had received laparotomy or laparoscopic radical resection of rectal cancer at the Department of General Surgery of Nanjing Jiangbei People's Hospital were selected as research subjects.Preoperative blood lipids were measured.Based on lipid levels, patients were divided into the hyperlipidemia group(46 cases)and the normal blood lipid group(40 cases). Operative time, intraoperative blood loss, postoperative recovery outcomes, incidence of anastomotic fistula, and incidences of incision fat liquefaction and incision infections were compared between the two groups.SPSS21.0 was used for data analysis.Results:Compared with the normal lipid group, the operative time of the hyperlipidemia group was significantly longer and the amount of intraoperative blood loss was higher in the hyperlipidemia group, and the differences were statistically significant.Compared with the normal lipid group, the hyperlipidemia group showed a longer time to first postoperative flatus and to first postoperative oral intake, delayed drainage tube removal and ambulation, and longer hospital stays, with statistically significant differences.There were 17 cases of postoperative complications in the hyperlipidemia group(37.0%)and 4 cases in the normal lipid group(10.0%), and the difference was statistically significant( χ2=7.027, P=0.008). Conclusions:Hyperlipidemia has adverse effects on surgical outcomes and postoperative recovery for rectal cancer patients.

Clinical study of pancreatic duct stent in the treatment of hypertriglyceridemic pancreatitis / 中华肝胆外科杂志

Objective:To evaluate the effectiveness and safety of pancreatic duct stent under endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of patients with hypertriglyceridemic pancreatitis (HTGP).Methods:The clinical data of 66 patients with HTGP at the General Hospital of Ningxia Medical University from January 1, 2017 to June 1, 2020 were retrospectively analyzed. The patients were divided into two groups according to treatment methods: conservative group ( n=46) and stent group ( n=20). The incidence of complications, the rate of transfer to the intensive care unit (ICU) for intensive treatment, the acute physiology and chronic health evaluation (APACHE) II score at 48 hours after admission, the level of triglycerides, and the application interval of enzyme inhibitor were compared between groups. Results:There were 53 males and 13 females, aged (39.3±9.7) years. There were no deaths in both groups, all 20 patients in the stent group underwent successful pancreatic duct stenting. Compared with before treatment, the level of blood white blood cell, amylase, triglycerides, and APACHE II scores of patients in the conservative group and the stent group were both significantly reduced after treatment ( P<0.05). After treatment, the APACHE II score of stent group patients was significantly lower than that of the conservative group [2.00(2.00, 4.00) vs 4.00(3.00, 5.25), P<0.05]. The length of fasting, hospitalization, and the enzyme inhibitor application of patients in the stent group were significantly lower than conservative group ( P<0.05). The complication rate of the stent group was significantly lower than conservative group [ 10.0% (2/20) vs 41.3% (19/46), P<0.05]. Conclusion:Pancreatic duct stenting can quickly relieve clinical symptoms of HTGP patients, reduce length of hospital stay and improve prognosis, which means it is a safe and effective treatment strategy for HTGP.

Clinical and prognostic features of hypertriglyceridemic pancreatitis during pregnancy / 临床肝胆病杂志

ObjectiveTo investigate the clinical and prognostic features of hypertriglyceridemic pancreatitis (HTGP) during pregnancy. MethodsA total of 77 patients with acute pancreatitis in pregnancy who were admitted to The Affiliated Hospital of Southwest Medical University from January 2013 to June 2020 were enrolled as subjects, and according to the presence or absence of HTGP, they were divided into HTGP group with 38 patients and non-HTGP group with 39 patients. The two groups were compared in terms of the clinical features including age, pregnancy, laboratory markers, complication, and prognostic indices. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of ranked data between two groups. According to the trimester of pregnancy, the patients were divided into early pregnancy group with 4 patients, middle pregnancy group with 14 patients, and late pregnancy with 59 patients, and blood lipid levels were compared between groups; the Kruskal-Wallis H test was used for comparison between two groups or within each group. ResultsCompared with the non-HTGP group, the HTGP group had significantly higher mean age (t=-3.000, P=0.004) and proportion of patients with diabetes (χ2=8.867, P=0.003). Compared with the non-HTGP group, the HTGP group had a significantly higher proportion of patients with disease onset in the third trimester (P＜0.001) and a significantly lower serum level of sodium (Z=-6.328, P＜0.001). Compared with the non-HTGP group, the HTGP group had significantly higher incidence rates of acute peripancreatic fluid collection (76.3% vs 33.3%, χ2=14.342, P＜0.001) and systemic inflammatory response syndrome (81.6% vs 410%, χ2=13.310, P＜0.001). There were significant differences between the two groups in the length of hospital stay, the rate of admission to the intensive care unit, and hospital costs (Z=-2.077, χ2=11.537, Z=-3.525, all P＜0.05). The levels of total cholesterol and triglyceride in the third trimester were significantly higher than those in middle pregnancy (both P＜0.05). ConclusionCompared with the non-HTGP group, the HTGP group has a higher proportion of patients with disease onset in the third trimester of pregnancy, a higher risk of complications, a longer length of hospital stay, and higher hospital costs.

Aspirin intervenes in hyperlipidemia kidney damage by blocking endoplasmic reticulum stress in podocytes / 中华肾脏病杂志

Objective@#To investigate the effects and underlying mechanisms of aspirin on endoplasmic reticulum stress in podocytes induced by hyperlipemia.@*Methods@#Cultured podocytes were divided into four groups: control group, aspirin (100 μg/ml) group, oxidized low density lipoprotein (ox-LDL, 100 μg/ml) group, aspirin+ox-LDL group. The expression of protein kinase R-1ike endoplasmic reticulum kinase (PERK), eukaryotic translation initiation factor 2α (eIF2α), activating transcription factor-4 (ATF4) and CAAT/enhancer binding protein homologous protein (CHOP) at 6 h, 12 h, 24 h, 48 h were evaluated by real-time PCR. The related proteins of p-PERK and p-eIF2α at 24 h and ATF4 at 12 h were evaluated by Western blotting, respectively.@*Results@#The expressions of PERK, eIF2α peaked at 24 h, while ATF4 and CHOP peaked at 12 h in ox-LDL group and aspirin+ox-LDL group. Compared with control group, the expressions of PERK, eIF2α, ATF4 and CHOP were significantly higher in ox-LDL group at each times (all P<0.05). Compared with ox-LDL group, the expressions of the above indicators were significantly lower in aspirin+ox-LDL group at each times (all P<0.05). At 24 h, compared with control group, the expressions of p-PERK and p-eIF2α were significantly higher in ox-LDL group (both P<0.05). Compared with ox-LDL group, the expressions of p-PERK and p-eIF2α were significantly lower in aspirin+ox-LDL group (both P<0.05). At 12 h, the expression of ATF4 protein in each group was similar to that of mRNA. There were no significant difference in the expressions of all indicators between aspirin group and control group.@*Conclusions@#Hyperlipidemia may cause endoplasmic reticulum stress in podocytes by inducing phosphorylation of PERK and eIF2α, activating ATF4 transcription and inducing high expression of CHOP. Aspirin may partially block the PERK pathway, which may have protective effects for podocytes.

Analysis of the risk factors for severe hyperlipidemic acute pancreatitis / 中华胰腺病杂志

Objective@#To explore the risk factors for hyperlipidemic acute pancreatitis (HTGP).@*Methods@#The clincial data of 169 HTGP cases admitted in Capital Medical University Attached Xuanwu Hospital from September 2012 to December 2018 were retrospectively analyzed. Patients were divided into severe HTGP group (n=63) and mild or moderately severe HTGP group (n=106). Clinical data were compared between two groups and variables with statistically significance and clinical values were chosen and included for binary logistic regression to explore the independent risk factors for severe HTGP.@*Results@#Severe HTGP patients′ heart beat and respiratory rate were significantly higher than moderately severe or mild HTGP cases, while the percentage of patients with previous AP history in severe HTGP group was obviously lower than moderately severe or mild HTGP cases. There were no statistically significant differences on other baseline data and previous history. Severe HTGP patients had significantly higher white blood cell, mean platelet volume, erythrocyte sedimentation rate, total protein, C-reaction protein on first day, C-reaction protein on third day, amylase, lipase, triacylglycerol, prothrombin time, D-dimer, fibrinogen, CTSI, APACHEⅡ score and Ranson score than those in moderately severe or mild HTGP cases; the lymphocyte count, albumin-globulin ratio, uric acid, apolipoprotein-A1, blood calcium, prothrombin activity were obviously lower than those in moderately severe or mild HTGP cases; and all the differences were statistically significant. Triglyceride and CRP on the first and third day, CTSI, APACHEⅡ score and Ranson score were included for binary logistic regression model, and the results showed that triglyceride on the first day (OR=1.08, 95% CI 1.02-1.14, P=0.01), C-reaction protein on the third day (OR=1.01, 95% CI 1.00-1.01, P<0.01), CTSI score(OR=1.51, 95% CI 1.06-2.13, P=0.02), APACHEⅡ score(OR=1.22, 95% CI 1.07-1.40, P<0.01)were the risk factors of severe HTGP, while triglyceride on the third day (OR=0.8, 95% CI 0.69-0.91, P=0.00)was the protective factor of severe HTGP.@*Conclusions@#Triglyceride on the first day, C-reaction protein on the third day, CTSI score and APACHEⅡ score were the risk factors of severe HTGP, which deserve special attention.

Advances in the treatment of hypertriglyceridemic pancreatitis / 临床肝胆病杂志

The incidence rate of hypertriglyceridemic pancreatitis (HTGP) is gradually increasing, and its complex pathogenesis has not been fully elucidated, which causes the difficulty in treatment. At present, there are no recommended guidelines for the treatment of HTGP. According to the process of the development and progression of HTGP, this article reviews related articles in China and foreign countries from the aspects of treatment during acute exacerbation, treatment for the special population, and long-term prevention of recurrence.

Effects of different transdermal penetration enhancers applied to herbal cake-partitioned moxibustion on liver lipids, HSL and HMG-CoA reductase in hyperlipidemia rabbits / 针灸推拿医学（英文版）

Objective: To observe the effects of laurocapram and borneol as transdermal penetration enhancers applied to herbal cake-partitioned moxibustion on liver lipids, hormone-sensitive lipase (HSL) and hydroxymethylglutaryl CoA (HMG-CoA) reductase in hyperlipidemia rabbits.Methods: Forty New-Zealand rabbits were randomly divided into 5 groups using the random number table method, with 8 rats in each group. Rabbits in the blank group were fed routinely with a normal diet; rabbits in the other groups were fed with high-fat diet for 12 weeks to establish the hyperlipidemia model. Rabbits in the blank and the model groups were not given any intervention. After the model was prepared successfully, rabbits in the non-transdermal penetration enhancer group received herbal cake-partitioned moxibustion without transdermal penetration enhancers; rabbits in the laurocapram group and the borneol group received herbal cake-partitioned moxibustion with laurocapram or borneol respectively. After 4 weeks of treatment, the serum was isolated and enzyme-linked immunosorbent assay (ELISA) was applied for the detection of HSL and HMG-CoA reductase. The liver tissues were isolated, and total cholesterol (TC) and triglycerides (TG) were measured by enzymatic methods. One-step method was applied for high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) detection, and transmission turbidimetry was for apolipoprotein A1 (Apo-A1) and apolipoprotein B (Apo-B) detection. Results: The serum concentrations of the drugs in the laurocapram and the borneol groups were significantly higher than those in the non-transdermal penetration enhancer group (both P<0.05); all drug penetrations in the borneol group were significantly higher than those in the laurocapram group (both P<0.05), except for tanshinone ⅡA. Compared with the non-transdermal penetration enhancer group, the HSL was significantly increased while the HMG-CoA reductase was significantly decreased in the laurocapram and the borneol groups (both P<0.05); between groups, the HSL in the borneol group was significantly higher than that in the laurocapram group (P<0.05). Compared with the blank group, the levels of LDL-C, TG, TC and Apo-B in rabbit liver were significantly increased in the model group (P<0.05); compared with the model group, the levels of LDL-C, TG, TC and Apo-B in the non-transdermal penetration enhancer, the laurocapram, and the borneol groups were significantly decreased (all P<0.05); between groups, the TG and TC in the laurocapram group and the LDL-C, TG, TC and Apo-B in the borneol group were significantly lower than those in the non-transdermal penetration enhancer group (all P<0.05), and the TG, LDL-C and Apo-B in the borneol group were significantly lower than those in the laurocapram group (all P<0.05). Compared with the blank group, the HDL-C and Apo-A1 were significantly decreased in the model group (both P<0.05), while compared with the model group, the HDL-C and Apo-A1 were significantly increased in the non-transdermal penetration enhancer, the laurocapram, and the borneol groups (all P<0.05). Between groups, the Apo-A1 in the laurocapram group, the HDL-C and Apo-A1 in the borneol group were significantly higher than those in the non-transdermal penetration enhancer group (all P<0.05).Conclusion: The application of laurocapram and borneol, as transdermal penetration enhancers, in herbal cake-partitioned moxibustion can promote the penetration of the drugs in the herbal cake, increase the levels of HDL-C and Apo-A1, improve the metabolism of HSL and HMG-CoA reductase, and also simultaneously reduce the levels of TC, TG, LDL-C and Apo-B in the liver. The transdermal penetration enhancement effect of borneol is slightly better than or equivalent to that of laurocapram.

Elegibilidad para la indicación de inhibidores de PCSK9 según las recomendaciones de diferentes sociedades científicas / Eligibility for the indication of PCSK9 inhibitors according to the recommendations of different scientific societies

La reducción del colesterol-LDL (C-LDL) es un objetivo primordial en prevención cardiovascular. Estudios recientes demostraron beneficio clínico al administrar inhibidores de la proprotein convertase subtilisin/kexin-9 (iPCSK9) a pacientes que no habían logrado la meta de C-LDL con estatinas de alta intensidad y ezetimibe, sin embargo el uso de estos fármacos está limitado por su costo. El American College of Cardiology, la Sociedad Argentina de Cardiología y la European Society of Cardiology recomiendan una meta de C-LDL menor a 70 mg/dl en prevención secundaria, determinando umbrales de C-LDL de 70, 100 o 140 mg/dl respectivamente, para iniciar el tratamiento con iPCSK9. Con el objetivo de evaluar el esquema hipolipemiante prescripto en internados por síndrome coronario agudo o revascularización coronaria y analizar la proporción de elegibles para ser tratados con iPCSK9 en un escenario real y simulado, realizamos un estudio que incluyó 351 pacientes con enfermedad coronaria, tomados de una base de datos electrónica de un hospital universitario. El 48.4% recibió estatinas de elevada intensidad, 11.4% ezetimibe y 54.7% no logró la meta de C-LDL menor a 70 mg/dl. Utilizando un modelo de simulación en el que todos serían medicados con estatinas de elevada intensidad y ezetimibe, la elegibilidad para prescribir iPCSK9 fue de 31.1%, 12.8% y 9.1% según los umbrales de C-LDL determinados por las tres sociedades científicas. Nuestro estudio demostró una brecha entre las recomendaciones de los consensos para reducir el colesterol y la práctica habitual que debería ser minimizada para optimizar la relación costo/efectividad en prevención secundaria.

LDL-cholesterol (LDL-C) lowering is a primary objective in cardiovascular prevention. Recent studies demonstrated clinical benefit when proprotein convertase subtilisin/kexin-9 inhibitors (PCSK9i) were added to the treatment in patients who had not achieved the LDL-C goal despite being treated with high intensity statins and ezetimibe, however the use of these drugs is limited by their cost. The American College of Cardiology, the Argentine Society of Cardiology and the European Society of Cardiology recommend an LDL-C goal less than 70 mg/dl in secondary prevention, determining thresholds of LDL-C to start treatment with PCSK9i of 70, 100 or 140 mg/dl respectively. In order to evaluate the lipid-lowering regimen prescribed in patients hospitalized for acute coronary syndrome or coronary revascularization and analyze the proportion of eligible to be treated with PCSK9i in a real and simulated scenario, we conducted a study that included 351 patients with coronary disease collected from an electronic database of a university hospital. The 48.4% received high intensity statins, 11.4% ezetimibe and 54.7% did not achieve the LDL-C goal of less than 70 mg/dL. Using a simulation model in which all would be treated with high intensity statins and ezetimibe, the eligibility to prescribe PCSK9i was 31.1%, 12.8% and 9.1% according to the C- LDL thresholds determined by the three scientific societies. Our study demonstrated a gap between the consensus recommendations for LDL-C lowering and the current practice that should be minimized to optimize the cost/effectiveness ratio in secondary prevention.

Dyslipidemia in Adolescents Seen in a University Hospital in the city of Rio de Janeiro/Brazil: Prevalence and Association / Dislipidemia em Adolescentes Atendidos em um Hospital Universitário no Rio de Janeiro/Brasil: Prevalência e Associação

Abstract Background: Early exposure to obesity favors greater risks of cardiovascular factors such as dyslipidemia. Objectives: To establish the prevalence of dyslipidemia, and to evaluate its association with nutritional status of the adolescents attended at the ambulatory of the Adolescent Health Studies Center of the University Hospital Pedro Ernesto. Methods: This is a cross-sectional, observational study, the sample of which was of convenience, consisting of adolescents from 12 to 18 years old of both genders. The lipid profile was evaluated, along with its association with the anthropometric indicators: body mass index and waist circumference. For statistical analysis, a significance level of 5% was used. Results: A total of 239 adolescents, 104 boys (43.5%) and 135 girls (56.5%) were evaluated and, of these, 52 (21.8%) were eutrophic, 60 (25.1%) overweight, and 127 (53.1%) obese. Obeseadolescents had significantly lower mean values of HDL-cholesterol (44.7 mg/dl vs 53.9 mg/dl; p < 0.001) and higher triglycerides (109.6 mg/dl vs 87.3 mg/dl; p = 0.01). The changes with higher prevalence were low HDL-cholesterol (50.6%), hypercholesterolemia (35.1%), and hypertriglyceridemia (18.4%). A negative association of HDL-cholesterol with body mass index and a positive association of triglycerides with body mass index could be observed, even after adjustment for gender and skin color. Conclusion: This study demonstrated high prevalence of dyslipidemia among adolescents. In view of the significant association between lower levels of HDL-cholesterol and increased triglycerides with overweight, the control of these factors should receive attention, with the precocious diagnosis of the dyslipidemia being important, mainly if it is associated with another cardiovascular risk, to develop effective intervention strategies.

Resumo Fundamentos: Exposição precoce à obesidade favorece maiores riscos de fatores cardiovasculares como dislipidemias. Objetivos: Estabelecer a prevalência de dislipidemia e avaliar sua associação com o estado nutricional de adolescentes atendidos no ambulatório de atenção secundária do Núcleo de Estudos da Saúde do Adolescente do Hospital Universitário Pedro Ernesto. Métodos: Estudo transversal observacional, cuja amostra foi de conveniência e compreendeu adolescentes de 12 a 18 anos de ambos os sexos. Avaliado o perfil lipídico e sua associação com os indicadores antropométricos: índice de massa corporal e circunferência da cintura. Para as análises estatísticas foi utilizado nível de significância de 5%. Resultados: Foram avaliados 239 adolescentes, 104 meninos (43,5%) e 135 meninas (56,5%) e destes, 52 (21,8%) apresentaram eutrofia, 60 (25,1%) sobrepeso e 127 (53,1%) obesidade. Os adolescentes com obesidade apresentaram valores médios de HDL-colesterol significativamente menores (44,7 mg/dl vs. 53,9 mg/dl; p < 0,001) e triglicerídeos maiores (109,6 mg/dl vs. 87,3 mg/dl; p = 0,01). As alterações com maior prevalência foram HDL-colesterol baixo (50,6%), hipercolesterolemia (35,1%) e hipertrigliceridemia (18,4%). Foi possível observar associação negativa do HDL-colesterol com o índice de massa corporal e associação positiva dos triglicerídeos com o índice de massa corporal, mesmo após ajuste para gênero e cor da pele. Conclusão: Este estudo demonstrou alta prevalência de dislipidemia entre os adolescentes. Tendo em vista a associação significativa entre baixos níveis de HDL-colesterol e triglicerídeos aumentados com excesso de peso, o controle destes fatores deve receber atenção, sendo importante o diagnóstico precoce da dislipidemia principalmente se associada a outro risco cardiovascular, para desenvolvimento de estratégias de intervenção.

Diagnosis and treatment of pregnancy complicated with hyperlipidemic pancreatitis: a report of 12 / 中国医师杂志

Objective To investigate the clinical characteristics,diagnosis and treatment of pregnancy complicated with hypedipidemic pancreatitis (HLAP).Methods The clinical data of 12 patients with hyperlipidemic pancreatitis in our hospital from 2010 to 2017 were analyzed retrospectively,including general data,clinical manifestations,laboratory examinations,imaging examinations,treatment methods and prognosis.Results 12 cases of HLAP were mainly occurred in the middle and late pregnancy and often recurs.The main cause of the disease was the high fat diet.The main manifestations of the disease are abdominal pain and vomiting.It may be accompanied by gestational diabetes or hypothyroidism.Blood amylase and lipase are often not significantly elevated,with pseudohyponatremia and abnormal coagulation function.Ultrasonography and computed tomography (CT) are important methods for the diagnosis of HLAP.In 12 cases of HLAP,except for one abortion,all the other 11 cases were successfully treated.Conclusions For pregnancy complicated with hyperlipidemic pancreatitis,prevention is the first,and the key is the correct diagnosis.After combined treatment,the patients usually have a good prognosis.

Effects of Zhibitai capsule on blood lipids,blood glucose and the adipocytokine omentin in hyperlipidemic rats / 中国基层医药

Objective To study the effect of Zhibitai capsule on blood lipids,blood glucose and omentin in hyperlipidemic rats. Methods Thirty SPF male rats were randomly divided into control group,model group and Zhibitai group. The control group was fed with common diet,while the rest rats were fed with high - fat diet. After the model was successfully established,the Zhibitai group was orally administered 8mg/ kg Zhibitai capsule powder twice daily,the rats in the control group and the model group were given the same amount of normal saline respectively. After 4 weeks,the serum levels of total cholesterol (TC),triglyceride (TG),high density lipoprotein (HDL - C),low density lipoprotein (LDL - C),blood glucose and omentin were evaluated. Results Compared with the model group, the serum levels of TC[(3. 97 ± 0. 62) mmol/ L vs. (6. 33 ± 1. 10) mmol/ L,t = 5. 910,P < 0. 01],TG[(1. 51 ± 0. 47)mmol/ L vs. (2. 18 ± 0. 64)mmol/ L,t = 2. 472,P < 0. 05]and LDL - C[(0. 30 ± 0. 04)mmol/ L vs. (0. 48 ± 0. 16)mmol/ L,t = 3. 451,P < 0. 01)] of the Zhibitai group were significantly decreased,the HDL - C level was significantly increased[(1. 35 ± 0. 28) mmol/ L vs. (1. 06 ± 0. 31) mmol/ L,t = 2. 195,P < 0. 05],blood glucose decreased significantly[(5. 04 ±0. 82)mmol/ L vs. (6. 43 ± 1. 10)mmol/ L,t = 3. 204,P < 0. 01],and the concentration of omentin was significantly increased[(68. 59 ± 24. 82) ng/ L vs. (46. 86 ± 20. 12) ng/ L,t = 2. 151,P < 0. 05]. Conclusion Zhibitai capsule can effectively reduce the serum levels of TC,TG and LDL - C of hyperlipidemic rats and increase the content of HDL - C,effectively reduce blood sugar,and can increase the content of omentin.

Expression and significance of mir-345-5p in serum of patients with hyperlipidemic acute pancreatitis / 解放军医学杂志

Objective To investigate the expression of miR-345-5p in peripheral blood of patients with hyperlipidemic acute pancreatitis (HAP) and its clinical significance. Methods From December 2017 to September 2018, 40 patients with HAP (group A) and 75 patients with non-HAP (group B) admitted to the general surgery center of the General Hospital of Western Theater Command were enrolled. 25 patiens with hyperlipidemic non-acute pancreatitis patients (group C) and 30 healthy volunteers (group D) were selected as the control group. Group A was subdivided into H-MAP group and H-SAP group. All the patients were examined for serum triacylglycerol and amylase biochemical levels, and scored on the APACHE II. The expression level of miR-345-5p in serum was detected by real-time fluorescent quantitative PCR. The relationship between miR-345-5p expression level and clinical indicators of HAP was analyzed and the role of miR-345-5p in predicting the severity of acute pancreatitis evaluated. Results The expression level of miR-345-5p in serum of group A (2.28±0.23) was significantly higher than that of groups B (0.35±0.21), C (0.29±0.23) and D (0.25±0.33). The difference was statistically significant (P0.05). The ROC curve analysis showed that the area under the curve of miR-345-5p detection H-SAP was 0.785(0.634~0.935). The expression of miR-345-5p in the HAP severe group (2.95±0.46) was significantly higher than that in the mild HAP group (0.69±0.23), the difference was statistically significant (P0.05). Conclusion The serum miR-345-5p is significantly up-regulated in HAP, and it increases with the severity of the disease, which may provide a new way for the clinical diagnosis and severity assessment of HAP.

Influence of Naoxintong capsule on vascular endothelium and hemorheology in patients with coronary heart disease and hyperlipidemia / 心血管康复医学杂志

Objective :To explore influence of Naoxintong capsule on vascular endothelial function and hemorheology in patients with coronary heart disease (CHD) and hyperlipidemia .Methods :A total of 112 CHD patients with hy‐perlipidemia were equally divided into routine treatment group (received routine western medicine treatment ) and Naoxintong group (received Naoxintong capsule based on routine treatment group ).Therapeutic effect ,vascular en‐dothelial function and hemorheological indexes before and after treatment were compared between two groups .Re‐sults :After treatment ,total effective rate of Naoxintong group was significantly higher than that of routine treat‐ment group (94. 64% vs.76.78%, P＝0. 025).Compared with routine treatment group after treatment ,there were significant rise in serum levels of nitric oxide (NO) [ (36. 36 ± 0.43) μmol／L vs.(43. 78 ± 0.72) μmol／L] and nitric oxide synthetase (NOS) [(16. 48 ± 0.78) U／L vs.(30. 25 ± 0. 93) U／L] ,and significant reductions in serum levels of von Willebrand factor (vWF) [ (146.37 ± 0.66)% vs.(132.71 ± 0.85)%] and endothelin‐1 (ET‐1) [ (7. 17 ± 0. 41) ng／ml vs .(5. 40 ± 0.50) ng／ml] , P＝0.001 all ;significant reductions in levels of whole blood low shear viscosity [ (12.28 ± 0.55) mPa·s vs.(9. 17 ± 0.44) mPa·s] ,whole blood high shear viscosity [ (5.38 ± 0.39) mPa·s vs. (4.61 ± 0. 43) mPa·s] ,plasma viscosity [(2. 00 ± 0.17) mPa·s vs.(1.53 ± 0.11) mPa·s] and hematocrit [(45. 61 ± 0.59)% vs.(41. 13 ± 0.53)%] in Naoxintong group , P＝0. 001 all.Conclusion :Naoxintong capsule based on rou‐tine treatment can significantly improve vascular endothelial function and hemorheological indexes in CHD patients with hyperlipidemia .